Inspection on 04/03/10 for Acacia House

This is the latest available inspection report for this service, carried out on 4th March 2010.

CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Acacia House 12/07/05

Acacia House 26/01/05

Acacia House 18/01/05

Acacia House 13/07/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Acacia House 37a School Road Newborough Peterborough PE6 7RG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Joanne Pawson     Date: 0 4 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Acacia House 37a School Road Newborough Peterborough PE6 7RG 01733810000 F/P01733810011 acacia@communitycaresolutions.com www.communitycaresolutions.com Community Care Solutions Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Anita Barber Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 5 The registered person may provide the following categories of service only: Care Home only - Code PD, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD, Learning Disability - Code LD Date of last inspection Brief description of the care home Acacia House is a care home for up to five adults who have a learning disability. The home is a modern bungalow, which has been substantially extended and adapted to meet the National Minimum Standards for Care Homes for Adults. Accommodation comprises five bedrooms all with en-suite facilities (two of which also have showers). In addition service users have access to a large lounge, dining room, kitchen and Care Homes for Adults (18-65 years) Page 4 of 23 Over 65 0 0 5 5 Brief description of the care home laundry room and the home has sufficient office space. To the rear is an area of raised decking with ramped access to a garden area, and a long driveway at the front provides off road parking for staff and visitors. Practical and emotional support is provided by staff 24 hours a day including waking night staff. The fee charged to service users ranges from £1250 to £1500. Care Homes for Adults (18-65 years) Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that the people who use the service receive excellent quality outcomes. During this inspection we met with some of the service users, the manager and some of the care staff. We case tracked three of the service users. Case tracking means speaking with some of the service users, visiting their rooms and speaking to the staff that care for them. We compared what we saw and heard with the individuals records. We also looked around the other areas of the home. Care Homes for Adults (18-65 years) Page 6 of 23 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential service users needs are assessed to ensure that the home can meet their needs. Evidence: The home did not have any recent admissions, but all three case tracked files contained the admission assessments that were completed at the time the service users moved into the home. The pre admission assessments are detailed and cover all of the necessary information the homes requires to ensure that they can meet the service users needs. Care Homes for Adults (18-65 years) Page 9 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have the information they need to support the service users to make decisions about their lives. Evidence: The manager told us that the care plans had been changed to a new format. We looked at the care plans for the three residents we were case tracking. The care plans included all of the information staff need and are written in a way that promoted the service users independence and dignity. One care plan we looked at said I like to be as independent as possible. Thus I have limited support from my carers. The care plans contained information on communication, mobility, general health, sociability, routines and behaviours, medication and other important areas. Each service user also has a health support plan where any medical issues are recorded. This allows easy monitoring of any health issues. Any appointments with health professionals are recorded. Care Homes for Adults (18-65 years) Page 10 of 23 Evidence: The service users are encouraged to take calculated risks with support from staff to minimise the risk. One service user had a risk assessment for making hot drinks which stated I can scald myself whilst pouring hot water from the kettle into the cup or mug. Staff have to ensure that the kettle is not heavy for me to lift. Each care plan we looked at contained comprehensive risk assessments for the service user. Any limitations on freedom are documented e.g. I need support when I access the community as I do not have any sense of danger. The minutes from the monthly service users meetings show that the service users are consulted on issues that effect their daily lives. The service users are asked for suggestions for daily activities and menus and any other issues they would like to discuss. We observed service users helping to lay the table for lunch and clear away their bowls and cutlery and sweep up after lunch. The staff told us that all of the service users are encouraged to take part in the household chores although some will participate more than others. Care Homes for Adults (18-65 years) Page 11 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are encouraged and supported to attend various daily and leisure activities. Evidence: All of the service users are supported to attend classes at the local college. One of the regular classes the service users attend is drama. The service users were recently involved in putting on a performance to the public and have another one planned for March. One service user confirmed that she enjoys attending college. Although service users attend regular activities if they do not want to attend on a particular day they can choose to stay at home. On the day of the inspection one service user had been upset and instead of going to college went for a long walk with his keyworker. The service users take part in various leisure activities including bowling, swimming and going to the cinema. Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: We saw photos of service users holidays and the manager told us that holidays have been booked for this year after consultation with the service users. Care Homes for Adults (18-65 years) Page 13 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive care and support in the manner they prefer. Evidence: The care plans clearly state how the service users would like staff to support them with any personal care. The health plans also give clear information about the service users for the care staff and any health professionals involved in the service users care. Evidence of regular appointments with health care professionals was seen. There are risk assessments in place to advise staff how they should work with the service users when they are showing changes in their mood, behaviour and general well being. We looked at the medication administration records for the service users and found them to be accurate. Two members of staff sign for all medication administered. Care Homes for Adults (18-65 years) Page 14 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the appropriate training to protect the service users from harm. Evidence: The information supplied by the manager before the inspection confirmed that there had not been any complaints received by the home in the last twelve months. The complaints procedure is in the service users guide in picture format. All staff have attended training on the safeguarding of vulnerable adults. The manager stated that although staff are trained in restraint they have never had to use it and when the service users are upset staff accompany them to their bedroom and try to distract them by involving them in an activity that they enjoy. This was evidenced on the day of the inspection when a service user who had become distressed went out for a walk with his keyworker and returned feeling much happier and calmer. Care Homes for Adults (18-65 years) Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a very pleasant, safe place to live. Evidence: Acacia House is a bright, clean and homely place to live. The service users looked comfortable and happy with their surroundings. Three of the service users showed us their bedrooms. All three seemed proud of their bedrooms and personal belongings. The fact that the residents are treated as individuals is evidenced by their personalised bedrooms and personal items such as one service user having lots of wooden puzzles and another service user having model planes. The communal areas are bright and welcoming. Pictures are secured on the walls, minimising potential damage. Care Homes for Adults (18-65 years) Page 16 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have the necessary training to meet the individual needs of the service users. Evidence: The staff seen working with the service users had obviously built up a warm and caring relationship with them and knew and understood the individual personalities very well. One service user told us my staff are always nice, they look after me. We case tracked the files for three members of staff. This included looking at all of their recruitment, training and supervision records. Two of the members of staff commenced working off site before satisfactory references were received but the references had been received before the new staff started work with the service users. The criminal records bureau check had not been received for one member of staff but the manager confirmed that are always supervised when working with the service users. One service user gets involved in the recruitment process by attending the interview and asking the prospective staff members set questions. The prospective staff are also invited to meet the other service users so that they can be observed interacting with them. The manager stated that she does not view the references received for staff. As the Care Homes for Adults (18-65 years) Page 17 of 23 Evidence: person responsible for the staff working in the home it would be good practice for the manager to view the references and been involved in the final decision to employee a new member of staff. Records confirmed that staff receive supervision with their manager on a monthly basis. The staff spoken to during the inspection stated that they found the supervisions positive. One member of staff said its the best job Ive ever had. The staff induction includes several days off site learning about understanding challenging behaviour, dementia care, safeguarding vulnerable adults, food hygiene, medication, basic life support, nutrition, infection control, skills for care workbook, care principles, continence care, health and safety, report writing and fire training. The manager stated that new staff shadow existing staff until they are confident to work with the service users and if needed they could complete the relevant training courses for a second time until they were confident. The training matrix showed that all staff are up to date with mandatory training ( or are booked on refreshers) apart from the manager and the deputy manager. When we identified that the training was out of date for medication, moving and handling and fire safety the manager immediately booked herself on the relevant training. Because we believe that the manager will complete this training we will not make a requirement at this time. The manager must ensure in future that all staff have their mandatory training up to date. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in an open and transparent manner in the interests of the residents. Evidence: One of the service users stated Anita is a very nice manager she always spoils me rotten. A member of staff on shift during the inspection stated Anita is very supportive. The manager has worked in the home for several years and observation of her working with the service users clearly shows that she has a warm caring relationship with them. The manager has both the NVQ 4 in management and the registered managers award. The managers training for fire safety, moving and handling and medication administration were all out of date but were booked on the day of the inspection. There are monthly service users meetings where they are encouraged to make comments about anything that affects their daily lives such as the menu or where they would like to go. The home conducts an annual quality assurance survey. The results from the surveys are collated by the head office and report sent to the home. Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: The annual quality assurance assessment completed by the manager showed that all of the necessary policies and procedures are in place. We checked the records for the testing of the fire alarms and found them to be satisfactory. Adequate insurance cover is in place. There are monthly team meetings when the staff can discuss any issues in the home. A letter from a service users relative was seen which stated there home has wonderful caring staff, there is always a warm welcome and the home is always clean and tidy. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 32 18 All staff must have up to date mandatory training. To ensure staff have the necessary knowledge to meet the service users needs. 03/05/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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